Exploring how exercise and scarring of the heart’s upper chamber affects the risk of atrial fibrillation in veteran athlete populations, to understand the condition further and better protect against risks.
Exercise & lifestyle
Atrial fibrillation (AF) is the most common heart rhythm problem in adults and is caused by the upper chambers of the heart – the atrias beating irregularly. This results in the heart beating less effectively, leading to breathlessness and increased risk of stroke. Scar tissue in the left atria is often seen in AF patients as well as athletes and those who frequently exercise. It is thought that the scarring of this area may be responsible for the irregular heart rhythm. To investigate this mechanism, Dr Swoboda and his team studied a group of 106 veteran cyclists who had already undergone a heart imaging procedure known as cardiac magnetic resonance (CMR) which showed their present levels of left atrial scarring. These cyclists belonged to a larger research trial called VENTOUX and as part of this, they been fitted with an electrocardiogram (ECG) recorder, which measures their heart’s rhythm and records if they have any episodes of AF. They were measured for 2 years, and the results were analysed by Dr Swoboda’s team.
The research also presented an opportunity to investigate the effect exercise has on the risk of AF; while moderate, regular exercise reduces the risk of AF, it was thought that people who do a lot of exercise, particularly into their 50s were at increased risk of AF. The study population of veteran cyclists were asked to record their exercise activity in online training diaries, and this was also compared to the levels of AF in the group.
The team found that although left atrial scarring was more common in the group of cyclists compared to less active participants, it did not lead to an increased risk of AF. Furthermore, frequent exercise also did not raise the risk of AF, however, they did identify two things for the cyclists which did: slow heart rates (particularly overnight) and big increases in blood pressure when exercising. As many athletes have slower resting heart rates, and consistently exercise, it is important to understand their level or risk.
It is hoped that these findings will help fill in the picture of how athletes may be at risk for developing AF, and how steps can be taken to protect against it occurring. As all the participants in this study were men, Dr Swoboda and his team have begun recruiting veteran female endurance athletes so that the effect of exercise on heart rhythm can be observed for both genders. They also plan to expand their research into studying younger athletes, during their sporting primes.
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